| NPI | 1588779110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME110031) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 244087) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 244087) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME 110031) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2023-08-07 |